More doctors accused of putting unnecessary stents in patients

Andrea K. Walker, The Baltimore Sun

A Towson law firm has accused eight more doctors of playing a role in implanting unnecessary heart stents in patients at St. Joseph Medical Center, where cardiologist Dr. Mark Midei was accused of performing the procedure in hundreds of patients who didn't need them.

The law firm of Kenny & Vettori filed claims on behalf of 39 patients this month with Maryland's Health Care Alternative Dispute Resolution Office, which arbitrates malpractice cases. The claims are the latest in a string of legal actions against the embattled cardiologist and hospital.

As with previous claims against Midei, the complaints accuse the doctors of overstating a patient's condition to justify using stents, mesh tubes that hold open blocked arteries to improve blood flow. Stents are typically recommended for patients whose arteries are more than 50 percent or 70 percent blocked.

The complaints are the latest in a three-year ordeal that started in 2009 when Midei was first accused of putting the stents in patients who did not need them. The Midei case led to turmoil at the Towson hospital, which faced millions of dollars in lawsuits, a federal investigation, revenue declines and a drain of doctors and patients. Hospital officials announced earlier this year a deal to be bought by the University of Maryland Medical System.

Midei has denied any wrongdoing, saying that he did nothing inappropriate and that doctors across the country have recommended stents in similar circumstances. He said St. Joseph and its owner, Denver-based Catholic Health Initiatives, used him as a scapegoat as the hospital faced scrutiny from federal authorities.

Officials at St. Joseph, also named as defendant in the latest cases, said they were reviewing the complaints.

"St. Joseph Medical Center is aware that additional claims have been filed," the hospital said in a statement. "We take the allegations very seriously. We will develop our response and file it at the appropriate time with the dispute resolution office."

Most of the doctors named in the claims are accused of actually implanting the stents, while others performed medical procedures that justified the unnecessary medical procedures, the complaints allege.

Nair, who practices in Bel Air, said through a secretary that he did not know about the complaints and didn't understand why he would be named because he did not perform any of the stent implant procedures. He declined to comment further.

According to complaints, Nair performed procedures to measure the blockage in patients' arteries on five occasions. The complaints said Nair confirmed the inflated artery blockage estimates, justifying the stent procedures. Other doctors then implanted the stents.

Clarke also did not implant stents but measured the blockage in arteries that gave other doctors the go-ahead to perform stent procedures on three occasions, the law firm contends. Clarke could not be reached to comment.

When asked about the allegations that he implanted unnecessary stents on two occasions, Meilman said: "I was known as one of the most conservative guys in town." He added that he didn't know the claims had been filed and declined to comment further.

Mastali declined to comment, as did the practice manager for Drossner. The other doctors accused of implanting unnecessary stents in the complaints could not be reached.

Paul M. Vettori, the lead attorney for the patients, said the firm "took information submitted by our clients and had it reviewed by expert cardiologists who presented what we say in the complaint." He declined to discuss the allegations in detail while the cases are pending.

In some cases, more than one doctor implanted unnecessary stents in a single patient, the complaints contend. For instance, Midei, Prewitt and Mastali all implanted stents in a Baltimore City woman on four separate occasions beginning in February of 2006, according to documents.

Some of the doctors have been named in other legal actions over stents.

Wang made news last year when he was appointed to a state committee assigned to develop safeguards in stent procedures, despite having been accused of improper stenting in three legal claims. Mastali, whose medical license has expired, was also named in those claims.

An attorney for Midei, Stephen Snyder, said the complaints against additional doctors could back up his client's argument that his practices were no different than those of other doctors.

"The care delivered by Mark was no different than care provided to heart patients across the country," Snyder said in a statement. "St. Joe's was unwilling to look at other practitioners as it had its scapegoat. It should come as no surprise that allegations of impropriety against fellow practitioners, which may or may not be sustainable, are now being made."

The Maryland Board of Physicians revoked Midei's license, finding that he falsified patient records to justify the placement of unnecessary coronary stents. He challenged the decision in a Baltimore County court and lost. Midei also filed a defamation suit against his former employer that was dismissed because he had agreed not to sue when the hospital dismissed him in 2009.

Also this month, attorney Jay Miller, who had already filed cases on behalf of more than 200 clients, lodged complaints at the dispute resolution office for an additional 53 patients. The cases named Midei but no other doctors, according to documents.

A spokesman for Catholic Health Initiatives said the company does not comment on pending litigation.

A University of Maryland Medical System spokeswoman declined to comment about the new cases against St. Joseph, but said the merger is moving forward.

Under the state mediation process, either side can appeal the board's decision in court.